ASK AN EXPERT

Got a question about a health story in the news or a health topic? Here's your chance to get an answer. Send us your questions about general health topics, diet and fitness and mental health. If your question is chosen, it could be featured on CNN.com's health page with an answer from one of our health experts, or by a participant in the CNNhealth community.

Name*Location*Email*Question*

* CNN encourages you to contribute a question. By submitting a question, you agree to the following terms found below.

Select a topic? (optional)

You may not post any unlawful, threatening, libelous, defamatory, obscene, pornographic or other material that would violate the law. By submitting your question, you hereby give CNN the right, but not the obligation, to post, air, edit, exhibit, telecast, cablecast, webcast, re-use, publish, reproduce, use, license, print, distribute or otherwise use your questions(s) and accompanying personal identifying and other information you provide via all forms of media now known or hereafter devised, worldwide, in perpetuity. CNN Privacy Statment.

Thank you for your question!

It will be reviewed and considered for posting on CNNHealth.com. Questions and comments are moderated by CNN and will not appear until after they have been reviewed and approved. Unfortunately, because of the voume of questions we receive, not all can be posted.

Expert Q&A

I feelálike a new person after getting on the right meds

Commentáby Marybeth, Muskegon, Michigan

I don't have a question. However, I would like to make a comment. I found the antidepressant Lamictal to be a godsend. I feel like a new person since I've been taking it. I also take Neurontin, which really takes the edge off. I feel for the person who can't find the right medicine. Don't give up, keep trying new drugs.

Expert answer

Dear Marybeth,

I agree so completely with your sentiments that I thought we'd post your comment as a little source of encouragement for all the folks struggling with medications that aren't quite doing the job, and also so that I might expand a little on your thoughts.

First, you are not the only person who has found Lamictal (generic: lamotrigine) to be a godsend. I know many people whose lives were helped incredibly when it was added to their antidepressant regimen. In fact, I often tell people that if they have either unipolar or bipolar depression, they shouldn't come near giving up hope until they have tried it. Note, however, that many studies now show that it neither treats nor protects against manic episodes. Like all good medications, it has its limitations.

Here is the larger point: I have spent several decades both prescribing and doing studies on medications designed to address the biology of depression, and this is what the experience has convinced me of: Any given person's response to a medication is a crapshoot. I have seen people have a complete response to the first medication they try. I have seen people fail 10 medications and then experience a miracle cure on the 11th. I have seen depressed people fail antidepressants and respond to antipsychotics. I have seen psychotic people whose lives were turned around by an antidepressant. I have seen people who never found a drug that worked do well with therapy.

What we lack is a crystal ball to predict who needs what. Many people are studying the issue as I write, and it might be that in a few years, someone will find the magic formula, but I doubt it. Here's why: Although psychiatrists have literally hundreds of different diagnoses in their diagnostic manual, increasing data suggest that many of these diagnoses share underlying biological abnormalities. This, of course, is why antidepressants work for depression, but also work for anxiety, post-traumatic stress disorder, obsessive-compulsive disorder, panic disorder, eating disorders, etc. So I think it is very unlikely that we will ever find medications that are specific for specific problems. The brain doesn't work that way.

On the other hand, within any given diagnosis -- say depression -- there is huge variability between individuals. Although in general, depression is characterized by a series of abnormalities in the brain and body, every individual with depression is a little different, with a body and brain that tell the sad story of woe in a slightly different way. The differences between people with depression can be as large as the differences between the varying psychiatric disorders themselves.

If we can't even find a medication specific for a particular diagnosis, what are the odds we will be able to know ahead of time which medication will work for any given patient? If any given medication is just as likely to help one person with panic disorder and another person with depression as it is to help two people with depression, you can see that we've got a long way to go before the crystal ball is worth taking out of the closet. In fact, my sense of the emerging science of mood and anxiety disorders suggests to me that we will probably never be able to do this because the disorders themselves are inherently probabilistic because of the huge complexity of the systems involved in their production.

In the name of fair balance, I should tell you that many scientists would disagree with what I've been saying, and they may be right. Perhaps we will in the future develop technology that will allow us to look beyond diagnostic labels and into the actual neurobiological abnormalities of each individual to see what they specifically need. Maybe -- but if it ever happens, it's a long way in the future.

I have a very good buddy who is one of the world's leading brain tumor researchers, and he is just now beginning to get a handle on how to treat each tumor individually. My head spins when he talks to me, because the process is so complicated. And a tumor pales in comparison to the human heart, soul and brain when it comes to complexity.

So what is the practical upshot of all this? Maintain hope, even if you have tried medications to no good effect. It is easy to get discouraged when medications don't work or when they come with unbearable side effects. But many people give up too soon, not realizing that there is a medication with their name on it, if only they will patiently persist in trying all options.

Leave Your Answer

Name:(required)

Location:(required)

Comments are moderated by CNN, in accordance with the CNN Comment Policy below, and may not appear on this blog until they have been reviewed and deemed appropriate for posting. Also, due to the volume of comments we receive, not all comments will be posted.

CNN Comment Policy: CNN encourages you to add a comment to this discussion. You may not post any unlawful, threatening, defamatory, obscene, pornographic or other material that would violate the law. All comments should be relevant to the topic and remain respectful of other authors and commenters. You are solely responsible for your own comments, the consequences of posting those comments, and the consequences of any reliance by you on the comments of others. By submitting your comment, you hereby give CNN the right, but not the obligation, to post, air, edit, exhibit, telecast, cablecast, webcast, re-use, publish, reproduce, use, license, print, distribute or otherwise use your comment(s) and accompanying personal identifying and other information you provide via all forms of media now known or hereafter devised, worldwide, in perpetuity. CNN Privacy Statement.

The information contained on this page does not and is not intended to convey medical advice. CNN is not responsible for any actions or inaction on your part based on the information that is presented here. Please consult a physician or medical professional for personal medical advice or treatment.